JPH04129569A - Ventilation tube for middle ear cavity tube indwelling operation - Google Patents

Abstract

PURPOSE:To prevent ventilation from being made impossible and accelerate the discharge of an inner exudation and the ventilation of a middle ear by forming multiple vent holes. CONSTITUTION:In the tube insertion therapy through an ear drum 23 for exudative tympanitis, the ear drum 23 is slightly cut with a knife and the like, a ventilation tube 1 is held with a pair of small forceps and inserted into an external acoustic meatus 21, and the insertion inner end section 3B of the ventilation tube 1 is inserted into the cut port of the ear drum 23. When the ventilation tube 1 is inserted and held in the ear drum 23, an exudation in the middle ear cavity 25 is discharged through one vent hole 7 of the ventilation tube 1, and the ventilation of the middle ear cavity 25 is performed through the other vent hole 7. Even if one vent hole 7 is closed by the surface tension of the exudation, ventilation is performed through the other vent hole 7, and the exudation is somehow discharged. Ventilation is prevented from being made impossible, the discharge of the inner exudation and the ventilation of the middle ear can be accelerated for a long period, and a sufficient therapeutic effect can be expected.

Description

Detailed Description of the Invention (Industrial Application Field) The present invention is used to promote drainage of internal exudate and ventilation of the middle ear by inserting it into the middle ear cavity through the tympanic membrane when treating otitis media with effusion, etc. The present invention relates to a ventilation tube for middle ear tube placement.

(Prior art) The Eustachian tube has a pressure balancing function between the middle ear and the outer ear, and a function to appropriately excrete and clean secretions in the middle ear cavity.If this Eustachian tube function becomes malfunctioning for some reason, , the negative pressure within the middle ear cavity increases, causing hyperemia of the mucosa within the middle ear cavity to the left, causing exudate and secretion to increase excessively, resulting in otitis media with effusion.

Otitis media with effusion tends to last for a long time, and if left untreated or without proper treatment, it can cause pathological changes in the middle ear and eardrum, leaving aftereffects such as hearing loss, or progressing to adhesive otitis media or cholesteatoma otitis media. There are things to do.

One of the effective treatments for Eustachian tube dysfunction is transtympanic tube insertion therapy.

In this method, the eardrum is incised, exudate is sufficiently drained, and then a small pentylation tube is inserted through the incision and left in place in the eardrum for a certain period of time.

-a, the pendeletion tube has an outer peripheral part that is inserted and held into the middle ear cavity through the eardrum, and a pendeletion tube that is inserted through the inner part of the outer peripheral part to drain exudate from the eardrum, ventilate the middle ear, etc. The vent of the pendeletion tube inserted into the tympanic membrane is used to drain internal exudate and ventilate the middle ear, and is expected to treat the onset of middle ear cavity mucosal lesions.

Conventionally, such pendeletion tubes have been made of Teflon, silicone, polyethylene, etc., and the present applicant has proposed a pendeletion tube at least whose outer peripheral surface is made of hydroxyapatite in Japanese Patent Application Laid-Open No. 133971/1983. The present invention provides pendeletion tubes that can be indwelled for long periods of time without being rejected by living organisms due to the biocompatibility of hydroxyapatite.

(Problem to be Solved by the Invention) However, since all conventional ventilation tubes have only a single ventilation hole, if exudate blocks the hole due to surface tension, ventilation may become impossible. There is,
Without ventilation, exudate will not come out, creating a vicious cycle.

In order to solve these problems, two pendeletion tubes were sometimes inserted into the eardrum.
Because the eardrum is small, it is clinically extremely difficult to insert multiple pendeletion tubes.

The present invention has been devised in view of the above-mentioned circumstances. 1. An object of the present invention is to provide a pendeletion tube that eliminates the possibility of ventilation becoming impossible and can promote the drainage of internal exudates and ventilation of the middle ear. It is in.

(Means for Solving the Problems) In order to achieve the above object, the present invention has an outer peripheral part that is inserted and held in the middle ear cavity through the eardrum, and a part that penetrates the inner part of the outer peripheral part to prevent exudation inside the eardrum. The ventilation tube for middle ear cavity tube indwelling is provided with ventilation holes for excretion of fluid, ventilation of the middle ear, etc., characterized in that a plurality of the ventilation holes are formed.

(Function) Even if one vent hole is blocked by the surface tension of the exudate, ventilation is possible through the other vent hole, so the exudate will eventually be excreted. It can promote the excretion of exudate and ventilation of the middle ear.

(Example) An embodiment of the present invention will be described below with reference to the accompanying drawings.

FIG. 1 is a plan view of a ventilation tube for middle ear tube indwelling, and FIG. 2 is a half cross-sectional front view of the ventilation tube.

The pendeletion tube l has an outer circumferential part 3 that is inserted and held into the middle ear cavity through the eardrum, and an inner part 5 of this outer circumferential part 3.
It consists of

A part of the outer peripheral part 3 at the axial middle part of the pendeletion tube l is formed into a slightly reduced diameter part 3A, and an insertion inner end part 3B inserted into the inner side of the eardrum, and an outer peripheral part 3A which is inserted into the inner side of the eardrum. The insertion outer end portion 3C disposed in is enlarged in diameter.

Furthermore, the insertion inner end 3B has a tapered shape whose diameter gradually increases from the reduced diameter part 3A, making it easy to insert into the eardrum hole, while the insertion outer end 3C has a tapered shape that gradually increases in diameter from the reduced diameter part 3A. A stepped portion 3D is formed between the diameter portion 3A and the pendeletion tube 1 is configured to prevent it from falling into the middle ear cavity.

7 is a ventilation hole, two ventilation holes 7 are provided through the inner part 5,
In the embodiment, the two ventilation holes 7 are formed at positions equidistant from the center 0 of the pendeletion tube l.

Further, a recess 9 with a large inner diameter is formed on the insertion outer end 3C side of the inner portion 5, and this recess 9 makes it easier to insert a tube or the like for sucking out exudate into the opening 7A of each ventilation hole 7. ing.

In the case of this example, the dimensions of each part are that the overall length a in the axial direction is 2.7 ms+, and the outer diameter of the outer insertion end 3C is 3.5 m.
m, outer diameter C of reduced diameter part 3A is 2.5 mm, insertion inner end 3B
The outer diameter d of the recess 9 is 3 mm, the inner diameter e of the recess 9 is 2.8 mm, and the inner diameter of each vent hole 7 is 0.6 mm.

In order to increase its affinity for living organisms, hydroxyapatite [Ca, which has the same composition as human bone] is used.

(po41, (oul*)). Note that even if the pen narration tube 1 is formed by forming the skeleton of the shape from synthetic resin, metal, etc. and covering the outer peripheral surface with hydroxyapatite, It is possible to increase the affinity for living organisms.

This pen narration tube 1 can be manufactured, for example, by press-molding hydroxyapatite powder and cutting a block obtained by sintering.

Next, how this pen narration tube 1 is used will be explained.

3 and 4, 21 is the external auditory canal, 23 is the tympanic membrane, 25 is the middle ear cavity, 27 is the malleus, 29 is the incus bone, 3
1 is the stapes.

When performing transtympanic tube insertion therapy for otitis media with effusion, etc., first make a small incision in the eardrum 23 with a scalpel, etc., grasp the pennarration tube l with small forceps, insert it into the external auditory canal 21, and perform pennarration. The insertion inner end 3B of the tube 1 is inserted into the incision of the eardrum 23.

Then, the indwelling position is adjusted using a bib, and the reduced diameter portion 3A of the pen narration tube 1 is fitted into the incision of the eardrum 23 and held. At this time, the insertion outer end 3C engages with the outside of the incision of the eardrum 23, and prevents the pen narration tube 1 from falling into the eardrum 23.

When the pen narration tube 1 is inserted and held in the eardrum 23, exudate in the middle ear cavity 25 is discharged through one vent hole 7 of the ventilation tube 1, and is also discharged into the middle ear cavity through the other vent hole 7. 25 ventilation is provided.

Even if one vent hole 7 is blocked by the surface tension of the exudate, ventilation is performed through the other vent hole 7, so f
4. The exudate will eventually be excreted, therefore, there is no possibility that ventilation will become impossible, and the excretion of internal exudate and ventilation of the middle ear can be promoted over a long period of time, and a sufficient therapeutic effect can be expected. In addition, if necessary, insert the suction tube into the opening 7 of the ventilation hole 7.
It may be inserted into A to suck out the exudate.

When the symptoms have improved and the treatment for pimples has been completed, the pen narration tube l can be grasped with forceps or the like and taken out.

Note that the pen narration tube 1 may be provided with a wire or a bottle for removal at the insertion outer end 3C located on the removal side.

Next, another embodiment will be described with reference to FIGS. 5 to 7.

5 to 7 show plan views of pen narration tubes according to different embodiments, respectively.

These embodiments are similar to the embodiment described above in that two vent holes are formed in the inner portion 5, but differ from the embodiment described above in that the shapes of the two vent holes are different from each other.

That is, in the embodiment shown in FIG. 5, a circular vent hole 41 similar to the vent hole 7 and a large-diameter vent hole 43 are formed, and in the embodiment shown in FIG. In the embodiment shown in FIG. 7, a circular vent hole 45 is formed to prevent the hole from being blocked by the surface tension of exudate or secretion. A long groove-shaped ventilation hole 47 extending linearly with 41 is formed.

Then, the large-diameter ventilation hole 43 and the long groove-shaped ventilation holes 45 and 47 are positioned below the circular ventilation hole 41, and the eardrum 2
The circular ventilation hole 7 is used as a ventilation hole, and
The large-diameter ventilation hole 43 and the long groove-shaped ventilation holes 45 and 47 are used to discharge internal exudate, and by configuring them in this way, the inside! Excretion of exudate and ventilation of the middle ear can be further promoted.

In addition, in the example, the case where there are two ventilation holes was explained, but even if three or more ventilation holes are provided in one ventilation tube, the drainage of internal exudate and the ventilation of the middle ear can be promoted in the same way. Possible (Effects of the Invention) As explained above, according to the ventilation tube of the present invention, it is possible to eliminate the risk of ventilation becoming impossible, promote the excretion of internal exudates and ventilation of the middle ear, and improve treatment. It becomes possible to perform the following to a sufficient extent.

[Brief explanation of the drawing]

Fig. 1 is a plan view of a ventilation tube for middle ear tube placement, Fig. 2 is a front view in half section of the same, and Fig. 3 is an explanatory cross-sectional view showing how the ventilation tube is used.
FIG. 4 is an explanatory diagram showing how the ventilation tube is used as seen from the outer ear side, and FIGS. 5 to 7 are plan views of ventilation tubes according to different embodiments. In the figure, l is the ventilation tube, 3 is the outer periphery,
5 is the inner part, 7, 41, 43, 45° 47 are ventilation holes. Patent Applicant: Asahi Optical Industry Co., Ltd. Representative: Yu Nakano, Patent Attorney: 1)

Claims (2)

[Claims] (1) Comprising an outer peripheral part that is inserted and held into the middle ear cavity through the tympanic membrane, and a ventilation hole that is penetrated through the inner part of the outer peripheral part to drain exudate from the eardrum, ventilate the middle ear, etc. A ventilation tube for middle ear cavity tube placement, characterized in that a plurality of the ventilation holes are formed. (2) The ventilation tube for middle ear tube indwelling according to claim 1, wherein one of the plurality of vent holes has a long groove shape.